Zentralblatt für Chirurgie
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The "gold standard" treatment modality for extra-articular and combined intra-, extra-articular fracture of the distal femur is the condylar blade plate (CP). Large exposure of the distal femur with unavoidable iatrogenic trauma to the soft tissue surrounding the fracture site and perhaps the lack of stiffness of the eccentric lateral cortical location of the CP has been suggested to play a role in the high rate of infections and pseudarthrosis reported in the literature. ⋯ The DFN is a modular system sharing many components and almost all instrumentation with the AO-UFN and it is expected that the nail is much better in axial stiffness and strength than the condylar blade plate. The treatment of supracondylar femoral fractures should be improved by providing early weight bearing and accelerated fracture healing with a reduced incidence of delayed unions and infections.
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Biography Historical Article
[History of surgical instruments: 7. The first electrosurgical instruments: galvanic cauterization and electric cutting snare].
In 1854 the surgeon Albrecht Theodor Middeldorpf (1824-1868) published the first monography on the application of electrical current in surgical operations ("galvanocautery"). By galvanocautery Middeldorpf defined a procedure in which specially constructed parts of surgical instruments (usually thin platinum wires) were transformed into glowing heat by means of galvanic current from a zinc-platinum-battery. In this manner it was possible to perform dissection and destruction of tissue as well as coagulation of vessels for hemostasis. ⋯ The glowing platinum wire was later also applied as a light source of cystoscopes. Thus, galvanocautery enabled development of endoscopy. Modern diathermy with high-frequent alternating current was introduced in medicine by the Dermatologist Franz Nagelschmidt from Berlin.
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Systemic chemotherapy ensures better quality of life than supportive treatment alone in incurable patients. Mean survival for the total group of patients with gastric, pancreatic and colorectal cancer can be extended only by months, however, this does not preclude that in individual cases survival time may reach years. The future of tumor therapy consists in sooner treatment of early stages and improved adjuvant therapeutic methods.
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The modern hospice movement started in St. Christopher's Hospice, London. ⋯ Until 1990 there was not much of a hospice or palliative movement in Germany. In the early nineties an increasing interest could be recognized and since May 1997 there are 34 palliative care units in existence.